Abstract

Not long ago I was called by my brother’s doctor. He wanted to know if I would accept his judgment that the respirator for my brother should be turned off. Vince, age 81, had contracted West Nile virus, normally treated successfully in 99% of cases, but often lethal in 1%. My brother was in that 1%, with a fast onset of the disease and a no less rapid decline into a coma, all in one day. There was no pain or suffering. His doctor called me one month later for my decision. I had no hesitation in agreeing with him—despite knowing that some patients do come out of seemingly irreversible comas later, even much later, than that—a low probability, but not a certainty. But my brother had lived a long and...